Why do people fitted with hearing aids not wear them?

Objective: Age-related hearing loss is an increasingly important public health problem affecting approximately 40% of 55–74 year olds. The primary clinical management intervention for people with hearing loss is hearing aids, however, the majority (80%) of adults aged 55–74 years who would benefit from a hearing aid, do not use them. Furthermore, many people given a hearing aid do not wear it. The aim was to collate the available evidence as to the potential reasons for non-use of hearing aids among people who have been fitted with at least one. Design: Data were gathered via the use of a scoping study. Study sample: A comprehensive search strategy identified 10 articles reporting reasons for non-use of hearing aids. Results: A number of reasons were given, including hearing aid value, fit and comfort and maintenance of the hearing aid, attitude, device factors, financial reasons, psycho-social/situational factors, healthcare professionals attitudes, ear problems, and appearance. Conclusions: The most important issues were around hearing aid value, i.e. the hearing aid not providing enough benefit, and comfort related to wearing the hearing aid. Identifying factors that affect hearing aid usage are necessary for devising appropriate rehabilitation strategies to ensure greater use of hearing aids

Foraminiferal assemblages as palaeoenvironmental bioindicators in Late Jurassic epicontinental platforms: relation with trophic conditions

Foraminiferal assemblages from the neritic environment reveal the palaeoecological impact of nutrient types in relation to shore distance and sedimentary setting. Comparatively proximal siliciclastic settings from the Boreal Domain (Brora section, Eastern Scotland) were dominated by inner−shelf primary production in the water column or in sea bottom, while in relatively seawards mixed carbonate−siliciclastic settings from the Western Tethys (Prebetic, Southern Spain), nutrients mainly derived from the inner−shelf source. In both settings, benthic foraminiferal assemblages increased in diversity and proportion of epifauna from eutrophic to oligotrophic conditions. The proximal setting example (Brora Brick Clay Mb.) corresponds to Callovian offshore shelf deposits with a high primary productivity, bottom accumulation of organic matter, and a reduced sedimentation rate for siliciclastics. Eutrophic conditions favoured some infaunal foraminifera. Lately, inner shelf to shoreface transition areas (Fascally Siltstone Mb.), show higher sedimentation rates and turbidity, reducing euphotic−zone range depths and primary production, and then deposits with a lower organic matter content (high−mesotrophic conditions). This determined less agglutinated infaunal foraminifera content and increasing calcitic and aragonitic epifauna, and calcitic opportunists (i.e., Lenticulina). The comparatively distal setting of the Oxfordian example (Prebetic) corresponds to: (i) outer−shelf areas with lower nutrient input (relative oligotrophy) and organic matter accumulation on comparatively firmer substrates (lumpy lithofacies group) showing dominance of calcitic epifaunal foraminifera, and (ii) mid−shelf areas with a higher sedimentation rate and nutrient influx (low−mesotrophic conditions) favouring potentially deep infaunal foraminifers in comparatively unconsolidated and nutrient−rich substrates controlled by instable redox boundary (marl−limestone rhythmite lithofacies).This research was carried out with the financial support of projects CGL2005−06636−C0201 and CGL2005−01316/BTE, and University of Oslo, Norway−Statoil cooperation. M.R. holds a Juan de la Cierva grant from the Ministry of Science and Technology of Spain